Failure to Maintain Infection Control During Medication Administration and Resident Care
Penalty
Summary
Staff failed to maintain proper infection control practices during medication administration and resident care. In two separate instances, a Qualified Medication Aide (QMA) was observed administering eye drop medications to residents without performing hand hygiene beforehand. The QMA handled various items such as medication cards, water cups, and the medication cart before entering the residents' rooms and administering both oral and eye drop medications, but did not wash or sanitize her hands prior to these tasks. The QMA herself indicated uncertainty about glove use for eye medications but acknowledged the need for hand hygiene. The Director of Nursing confirmed that hand hygiene should be performed before administering eye drops. In another case, a resident with multiple diagnoses, including HIV, hepatitis B, Crohn's disease, and a colostomy, was observed keeping open containers of urine and feces on his bedside table, along with a urinal and food items nearby. The resident preferred to keep these containers to monitor his output, and staff had documented his refusal to allow removal or cleaning of the bedside table. Despite education and encouragement from staff to use appropriate disposal methods, the containers remained on the bedside table. The resident was under Enhanced Barrier Precautions due to risk factors such as an indwelling device and chronic wound. When a nurse consultant was notified about the presence of bodily fluids on the bedside table, she entered the resident's room, performed hand hygiene, donned gloves, and removed one of the containers, but did not wear a gown as required by the facility's Enhanced Barrier Precautions policy. Facility policies provided to surveyors specified the need for hand hygiene before and after resident contact and the use of gowns and gloves during high-contact care activities for residents under Enhanced Barrier Precautions.